Impact of renal denervation on tissue Na+ content in treatment-resistant hypertension
Impact of renal denervation on tissue Na+ content in treatment-resistant hypertension
复制标题
肾去神经支配对难治性高血压患者组织钠含量的影响
DOI：
10.1007/s00392-017-1156-4
复制
发表时间：
2018
影响因子：
5
通讯作者：
Schmieder RE
中科院分区：
文献类型：
--
作者：
Kopp C;Dahlmann A;Schmid A;Linz P;Cavallaro A;Hammon M;Ditting T;Veelken R;Uder M;Titze J;Schmieder RE
目的肾去神经术（RDN）已被引入用于降低难治性高血压（TRH）的血压（BP）。RDN如何发挥其降血压作用的确切机制尚未完全了解。钠离子（Na+）在高血压病的发病机制中起着重要作用。然而，有越来越多的证据表明，非活性Na+存储。我们调查了RDN对Na+稳态的影响，估计盐摄入量，和测量组织Na+content.MethodsIn研究41例TRH（办公室BP ≥140/90 mmHg和诊断证实24小时动态血压监测）进行RDN。在RDN前和RDN后6个月，采用3.0 T磁共振成像无创评估组织Na+含量。此外，24小时尿Na+排泄作为盐摄入量和现场尿Na+/K+排泄的估计进行了评估。该研究注册于 http://www.clinicaltrials.gov (ID：NCT 01687725）。结果RDN后6个月，血压显着下降（办公室：-17 ± 20/-10 ± 12 mmHg; 24小时：-11 ± 13/-6 ± 9 mmHg，allp< 0.001）。相比之下，RDN后肌肉（20.1 ± 3.9 vs. 20.7 ± 4.0 mmol/L，p= 0.229）和皮肤（24.4 ± 6.5 vs. 24.8 ± 6.6 mmol/L，p= 0.695）的组织Na+含量没有变化。此外，也没有变化，在盐的摄入量后RDN，而Na+/K+的比率只急剧increased.ConclusionsAlthough RDN导致血压大幅下降，组织Na+含量的肌肉和皮肤没有动员和减少。这些数据表明，RDN后血压下降与Na+稳态无关。
ObjectivesRenal denervation (RDN) has been introduced for reducing blood pressure (BP) in treatment-resistant hypertension (TRH). The precise mechanism how RDN exerts its BP-lowering effects are not yet fully understood. It is widely accepted that sodium (Na+) plays a crucial role in the pathogenesis of hypertensive disease. However, there is increasing evidence of osmotically inactive Na+storage. We investigated the impact of RDN on Na+homeostasis using estimation of salt intake, and measurement of tissue Na+content.MethodsIn a study 41 patients with TRH (office BP ≥140/90 mmHg and diagnosis confirmed by 24-h ambulatory BP monitoring) underwent RDN. Tissue Na+content was assessed non-invasively with 3.0 T magnetic resonance imaging before and 6 months after RDN. In addition, 24-h urinary Na+excretion as an estimate of salt intake and spot urine Na+/K+excretion were assessed. The study was registered at http://www.clinicaltrials.gov (ID: NCT01687725).ResultsThere was a significant fall in BP (office: −17 ± 20/−10 ± 12 mmHg; 24-h: −11 ± 13/−6 ± 9 mmHg, allp< 0.001) 6 months after RDN. In contrast, tissue Na+content of the muscle (20.1 ± 3.9 vs. 20.7 ± 4.0 mmol/L,p= 0.229) and skin (24.4 ± 6.5 vs. 24.8 ± 6.6 mmol/L,p= 0.695) did not change after RDN. Moreover, there was also no change in salt intake after RDN, whereas Na+/K+ratio only acutely increased.ConclusionsAlthough RDN resulted in a substantial reduction of BP, tissue Na+content of the muscle and skin was not mobilized and reduced. These data indicate that the BP reduction after RDN is unrelated to Na+homeostasis.
登录
查看更多内容
盐诱导的肾病脑反射激活肾素-血管紧张素系统并促进 CKD 进展
影响因子：
13.6
作者：
Cao, Wei;Li, Aiqing;Hou, Fan Fan
通讯作者：
Hou, Fan Fan
原发性高血压的内脏切除术
DOI：
--
发表时间：
2017
期刊：
影响因子：
--
作者：
R. Smithwick;Jesse E. Thompson
通讯作者：
Jesse E. Thompson
影响因子：
3.5
作者：
Grassi, Guido;Seravalle, Gino;Mancia, Giuseppe
通讯作者：
Mancia, Giuseppe
影响因子：
29
作者：
Rakova, Natalia;Juettner, Kathrin;Titze, Jens
通讯作者：
Titze, Jens
影响因子：
39.3
作者：
Langenfeld, RW;Schobel, H;Schmieder, RE
通讯作者：
Schmieder, RE